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Gul Zaman Khan Niazi , Nisar Ahmed , Arslan Masood , Ammar Akhtar , Muhammad Sohail Saleemi , Ijaz Ahmad


Objective: Diabetic neuropathy may mask the typical ischemic chest pain and diabetics may carry longer presentation times in cases of acute STEMI. Diabetics may complain of chest pain less frequently, while atypical clinical presentations of STEMI could be more common compared to non-diabetics. Aim of this study was to assess the potential impact of diabetes on STEMI related chest pain, its severity, characteristics and non-specific clinical features.

Methodology: The descriptive, cross-sectional study included 254 patients with first episode of STEMI. Data was acquired regarding feeling of chest pain, its severity, different characters, sites of radiation, and occurrence of associated clinical features. These variables were compared among diabetic and non-diabetic groups by Pearson’s Chi-square test.

Results: Diabetics were more likely ‘not to feel’ any STEMI related chest pain compared to non-diabetics (22.2% vs. 2.4% p<0.001), severe chest pain was a less frequent complaint in diabetics compared to non-diabetics (21.1% vs. 89% p<0.001). The characters of “chest tightness”, “strangulating pain” and “squeezing chest pain” were less frequent in diabetics (45.6% vs. 68.3% p<0.001, 8.9% vs. 56.7% p<0.001 and 1.1% vs. 18.3% p<0.001 respectively). Syncope and shortness of breath were observed more frequently in diabetics (37.8% vs. 20.7% p=0.003 and 23.3% vs. 17.1% p=0.001 respectively).

Conclusion: Diabetics can frequently present without pain or with less severe chest pain and infrequent typical characters compared to non-diabetics and may have atypical symptoms like syncope and shortness of breath more commonly than non-diabetics.

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